The integration of technology in the healthcare space improves operational efficiency in clinics, improves patient adherence to treatment and translates into improved health outcomes.
With the department of health’s National Adherence Guidelines, there are multiple innovative strategies to improve adherence of patients to treatment, ranging from cellphone apps to automated medicine-dispensing machines. Such innovation has been applied in townships such as Alexandra in Johannesburg.
The pharmacy dispensing units in Alexandra have decongested health facilities through reaching out to clinically stable patients who can now collect their medication at a nearby mall. With the widespread use of WhatsApp, virtual support groups have also emerged as one of the key aspects of interactions between patients, and between patients and adherence club facilitators. Such communication includes sharing health information and patients notifying the facilitator that they will miss or attend the next appointment date. Virtual support groups also come in handy for reminding patients of the next medicine pick-up times, and the value of adhering to treatment.
Adherence clubs are community-based support groups facilitated by a community healthcare workers that increase awareness and understanding about self-management of individual patients’ conditions. Adherence clubs comprise 30 patients allocated to a group that meets at either a facility or a community venue for less than an hour every two or three months, depending on the supply of medication. Adherence clubs are established to cater for individuals who are clinically stable and on antiretroviral treatment (ART) or other chronic medication for noncommunicable diseases. The patients in these clubs can now pick up their medication from the pharmacy dispensing units, which places less strain on the health sector.
WhatsApp’s integration into health service provision in adherence clubs has facilitated a peer support platform that is an essential component to health information sharing and experiential learning among chronic patients. In this era, where chronic patients are largely stable and busy with their day-to-day work, communication through WhatsApp has led to real-time access to correct information and social support from other patients and facilitators.
Patients not only get to share health information but are also able to discuss general social issues on the platform. In some instances group members also share job adverts and motivational messages to keep each other inspired. Through sharing of experiences patients are in a position to relate and understand that whatever challenges they are facing will soon come to pass, as others have also gone through the same experiences and have emerged victorious.
As artificial intelligence (AI) takes centre stage in the international scene, the introduction of automated pharmaceutical delivery units will slowly translate into the acceptance of robots that can prescribe or diagnose just as doctors do. This will also reduce stigma in the communities; the integration of various chronic patients into support groups has also reduced stigma. These initiatives have translated into the acceptance of some chronic ailments and increased family support. The patients are now in a position to go to work and many still adhere to medicine pick-up dates.
Through the use of such innovations, the Gauteng department of health, working in close collaboration with the district support partners and different donors, has taken the lead to ensure there is improved health service provision to chronic patients accessing medication on a regular basis. These initiatives need to be adopted and rolled out in other provinces and the SADC region. The use of technology in the health space will in the long run translate into improvements in the quality of services provided to communities. With the tremendous increase in population in urban areas it will also alleviate the workload of nurses.
With such advancements, it is only a matter of time before we visit a clinic and are attended to by a robot. Despite the high ART retention in formal health care facilities, many HIV-positive people struggle with frequent appointments to health care facilities and may drop out of care entirely. These innovations will change the health sector landscape, as they will aid patients to attain and maintain their healthcare goals, including adherence to medication regimens, receiving necessary treatment, attending appointments, and maintaining healthy behaviors. Such technological advancement can be utilised by government; we present suggestions for clinicians who want to incorporate technologies to help their patients better engage in their health care.
Dr Ndumiso Tshuma holds a PhD in Public Health, Master’s of Business Administration, postgraduate degree in Public Health Nutrition and a Bsc in Nutrition. He has over 10 years’ experience in the NGO sector in South Africa, Swaziland, Lesotho and Zimbabwe. His areas of interest include mhealth integration in disease prevention and treatment adherence. He has been the principal investigator and co-investigator in studies on mhealth and machine learning in the health space. Ndumiso has also conducted research studies in nutrition, maternal health, HIV and TB, non-communicable diseases, youth and adolescent health. His research output currently stands at more than 50 publications comprising journal articles, abstracts, books and technical reports. He is the public health specialist at The Best Health Solutions.